Clinical application of xenogenic (porcine) acellular dermal atrix (ADM) in scar treatment / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of xenogenic (porcine) ADM as dermal substitute in scar treatment.</p><p><b>METHODS</b>After scar excision, the wounds were covered with composite grafts of DR procine ADM and autologous thin split-thickness grafts in one stage or in two stages.</p><p><b>RESULTS</b>22 out of 47 cases were treated in two-staged procedure. After the ADMs were applied to the wound, the autologous thin split-thickness grafts were implanted 7 days later. 25 cases were treated in one-staged procedure. The survival rates of composite grafts were (88.3 +/- 3.7)% for subcutaneous recipient bed and (89.7 +/- 3.4)% for deep fascia recipient bed in group with two-staged procedure, compared with (92.5 +/- 4.1)% and (93.2 +/- 5.2)%, respectively, in group with one-staged procedure. Early after grafts taken, the grafts had a pink colour and smooth surface. The patients were followed up for 90 days at most. The survived composite grafts were durable, elastic, smooth and soft with good function and appearance like normal skin. They could even be pinched up. The scar along the edge of the grafts was slightly hypertrophic.</p><p><b>CONCLUSIONS</b>The survival rate of composite graft is higher in patients with one-staged procedure. The elasticity and textural of the taken grafts are better on subcutaneous recipient bed than on deep fascia recipient bed, though the function has no difference. Xenogenic (porcine) ADM can be an optimal dermal substitute for wound coverage after scar excision.</p>

Treatment of deep partial thickness burns by a single dressing of porcine acellular dermal matrix / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effect of one dressing of porcine acellular dermal matrix on deep partial thickness burns.</p><p><b>METHODS</b>From January 1997 to January 2004, sixty-seven cases of deep partial thickness total burned surface area (TBSA) from 50% to 90% burn wound were treated by a single dressing of porcine acellular dermal matrix (the porcine acellular dermal matrix group). Ten cases of deep partial thickness burned patients with the same TBSA treated by exposure method served as the exposure method group. The healing time of the wound was observed. The patients were followed up for 3 months to 2 years, and the scar proliferation was observed.</p><p><b>RESULTS</b>The deep partial-thickness wound would be healed without dressing change in the porcine acellular dermal matrix group, and the average healing time was (12.2 +/- 2.6) days. The average healing time of the exposure method group was (27.4 +/- 3.5) days. Follow up of the patients within 3 months to 2 years showed that scar proliferation in the porcine acellular dermal matrix group was much less than that in the exposure method group, even no scar proliferation was observed in some patients.</p><p><b>CONCLUSION</b>Without tangential excision, autografting and dressing change, a single dressing of porcine acellular dermal matrix on deep partial thickness burn wound could shorten the healing time and inhibit scar proliferation.</p>

Use of lower trapezius musculocutaneous pedicle flap in repairing of maxillofacial region penetrating defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate an safe and effective new technology (treatment) to repair maxillofacial region penetrating defect.</p><p><b>METHODS</b>The lower trapezius musculocutaneous flap is parallel just like as two leaves which is connected to each other, and was folded to provide the liner of oral cavity and external cover.</p><p><b>RESULTS</b>Totally twelve folding lower trapezius musculocutaneous pedicle flap survived. Postoperative follow-up for 1 approximately 3 years, the patients restored the function as well as the shape of maxillofacial region.</p><p><b>CONCLUSIONS</b>The lower trapezius musculocutaneous pedicle flap is a suitable material for maxillofacial region reconstruction, further more, the successful rate is perfect.</p>

A research of endothelial cell-targeted therapy for cure of hypertrophic scar / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of endothelial cell-targeted therapy to cure post-burn hypertrophic scar.</p><p><b>METHODS</b>A hypertrophic scar animal model was made. Intralesional injecting of VEGF monoclonal antibody was performed for three weeks. The changes of scar in volume and morphology were observed.</p><p><b>RESULTS</b>1. The volume of scar decreased. 2. The number of the capillary, the amount of collagen I and collagen III decreased. 3. Transmission electron microscope examinations demonstrated many dead or apoptotic fibroblasts and endothelial cells. Fibrocytes were seen relatively common.</p><p><b>CONCLUSION</b>VEGF induces the growth and development of hypertrophic scar in that it induces excessive and uncontrollable angiogenesis, which favors excessive collagen synthesis. Endothelial cell-targeted therapy may be a promising method to cure post-burn hypertrophic scar.</p>